EHA 2026 | Practical considerations for switching from ruxolitinib to momelotinib in patients with MF

Yes, so that one is actually answering a very practical question. Because, you know, ruxolitinib is a very powerful drug for symptoms and spleen and it’s a very potent JAK inhibitor with short half-life. So, what’s been known for a long time is that there is such a thing called ruxolitinib withdrawal or ruxolitinib discontinuation syndrome, where if you suddenly stop it, you can have a flare. And therefore, in this era of multiple JAK inhibitors, one has to know how to switch. And we’ve had fedratinib and pacritinib approved before momelotinib. And those two have long half-lives. And they don’t hit JAK1 as much. So for these reasons and ruxolitinib being a drug with a short half-life that hits both JAK1 and JAK2, for these reasons that switch can be tricky. And what many of us have learned to do is to taper the ruxolitinib and overlap a small dose of ruxolitinib with pacritinib or fedratinib and then keep the patients on pacritinib or fedratinib. Now, momelotinib is different because one, it hits JAK1 and JAK2 like ruxolitinib. Two, it also has a short half-life. So, what was already shown from SIMPLIFY-1 where people crossed over after six months from the ruxolitinib arm to the momelotinib arm was that you did not see this ruxolitinib discontinuation syndrome. You were able to switch the next day seamlessly. And so this particular, you know, poster at EHA this year looks at the same question and really does a more detailed analysis of the patients in SIMPLIFY-1 who were on the ruxolitinib arm, who then after six months, 24 weeks, crossed over to momelotinib. And the conclusion is the same, that you are able to do this. You don’t run into problems. You can just go literally the next day from last dose of ruxolitinib to the first dose of momelotinib.Yes, so that one is actually answering a very practical question. Because, you know, ruxolitinib is a very powerful drug for symptoms and spleen and it’s a very potent JAK inhibitor with short half-life. So, what’s been known for a long time is that there is such a thing called ruxolitinib withdrawal or ruxolitinib discontinuation syndrome, where if you suddenly stop it, you can have a flare. And therefore, in this era of multiple JAK inhibitors, one has to know how to switch. And we’ve had fedratinib and pacritinib approved before momelotinib. And those two have long half-lives. And they don’t hit JAK1 as much. So for these reasons and ruxolitinib being a drug with a short half-life that hits both JAK1 and JAK2, for these reasons that switch can be tricky. And what many of us have learned to do is to taper the ruxolitinib and overlap a small dose of ruxolitinib with pacritinib or fedratinib and then keep the patients on pacritinib or fedratinib. Now, momelotinib is different because one, it hits JAK1 and JAK2 like ruxolitinib. Two, it also has a short half-life. So, what was already shown from SIMPLIFY-1 where people crossed over after six months from the ruxolitinib arm to the momelotinib arm was that you did not see this ruxolitinib discontinuation syndrome. You were able to switch the next day seamlessly. And so this particular, you know, poster at EHA this year looks at the same question and really does a more detailed analysis of the patients in SIMPLIFY-1 who were on the ruxolitinib arm, who then after six months, 24 weeks, crossed over to momelotinib. And the conclusion is the same, that you are able to do this. You don’t run into problems. You can just go literally the next day from last dose of ruxolitinib to the first dose of momelotinib.

This transcript is AI-generated. While we strive for accuracy, please verify this copy with the video.